Homelessness, rape, partner abuse and other violent events associated with psychological distress are common occurrences in the lives of street sex workers and have not been considered in their impact on developing HIV prevention programs. Feelings of stigmatization due to the nature and illegal status of the occupation are likely to contribute to significant psychological distress. Psychological distress and drug dependency may, in turn, undermine the motivation and ability of sex workers to adopt safer sex behavior. Most HIV programs targeted to this population tend to ignore the multiple factors that are associated with sex work. Mental health and other basic services such as drug abuse treatment, public assistance, housing, education, and training for alternative employment are not integrated into HIV prevention approaches. Moreover, most HIV prevention programs for female sex workers are not culturally sensitive and fail to involve sex workers in designing an intervention reflective of the community's unique needs or infrastructure.